What Are Graduated Care Facilities?

As an elder’s abilities decline, the elder is likely to need increasing levels of care, which, if provided by the family members, can sorely stress the elder’s social world. I recommend creating elder care teams to address these growing needs. Some facilities provide many facets of the needed care for a declining elder in graduated steps.

Graduated care facilities (“GCF”), also known as continuing care retirement communities, are residential arrangements for persons who no longer are able to or choose to live independently. Many GCFs guarantee, for a substantial fee, lifetime housing, social structure, and increasing levels of care as the resident’s needs grow.

Generally, GCFs offer three levels of living assistance. First, independent living approximates apartment living, but the facility cafeteria offers a meal-option for residents, and onsite medical personnel are available as needed. Second, assisted living tailors a care plan to the needs of the individual, providing extensive but not-unlimited support of daily living activities for persons whose capabilities for self-care are declining. Third, a skilled nursing floor offers rehabilitation and end of life care, including, when appropriate, hospice care. Some GCFs have memory care wings, which provide security and compassionate special treatment for persons suffering dementia.

Financially, GCFs are the most expensive long term care option, except for remaining in one’s home and seeking twenty-four hour individual care. GCFs typically have a buy-in fee (usually $100,000 to $1,000,000) as well as a monthly fee that rises as the level of care provided increases.

Because of the substantial up-front investment, the financial stability of any GCF under consideration should be thoroughly investigated. And because your beloved elder may live in the facility for the rest of her life, one should systematically inspect in every phase of the GFC’s operations over a reasonable period of time. Penalties for early move-out can be substantial.

Two highly-respected GFCs in our area are Ida Culver House in the Broadview neighborhood and Bayview in the Queen Anne area.